Biceps Tendinitis

Biceps Tendinitis

Biceps tendinitis describes pain related to the long head of the biceps tendon from a variety of different etiologies. The biceps muscle travels along the humerus (upper arm bone) and attaches at two separate sites: one in the shoulder joint and one outside the shoulder joint. The long head of the biceps tendon passes through the shoulder joint to attached on the top of the labrum (superior labrum). An injury to the superior labrum is called a SLAP tear. Biceps tendinitis occurs when the tendon becomes inflamed, typically from repetitive shoulder use. Biceps tendinitis can occur alone or with other common shoulder diagnoses, such as impingement or rotator cuff tears.

Education

Symptoms

Patients with biceps tendinitis can feel pain in the front of the shoulder or pain deep in the shoulder. The pain can also radiate down the front of the arm. A clicking or snapping might be felt with shoulder motion, as the biceps tendon moves in the front of the shoulder. Occasionally, patients may feel a sense of weakness or fatigue in the arm.

Diagnosis

Biceps tendinitis is diagnosed using physical examination and imaging studies to confirm the diagnosis. The physical examination is used to identify areas of pain, weakness, and changes in range of motion of the shoulder. X-rays help evaluate for the presence of a bone spur or any arthritic changes of the shoulder joint. MRI (magnetic resonance imaging) allows us to evaluate the biceps tendon itself and other non-bony parts of your shoulder.

Treatment

Biceps tendinitis is very common and fortunately, the majority of patients improve with non-surgical treatment. This can include:

  • Rest

  • Modification of activities: Avoiding activities that irritate the shoulder, specifically overhead motions

  • Injections: Steroid injections with ultrasound guidance can help decrease inflammation in the sheath surrounding the biceps tendon, but should be used sparingly.

  • Physical therapy: This is an important tool to help you strengthen and retrain the muscles of the rotator cuff to work better together

Surgery may be an effective treatment for a small subset patients who do not improve with non-surgical measures.

  • Arthroscopic superior labral repair is performed in younger patients without significant biceps tendinitis

  • Arthroscopic or open biceps tenodesis is performed in patients with damage to the biceps tendon from biceps tendinitis. The damaged portion of the tendon is removed and the remaining healthy tendon is attached to the humerus bone.

  • Arthroscopic biceps tenotomy is another surgical option for patients with damage to the biceps tendon. The biceps tendon is released from its attachment to the labrum.

Disclaimer: The information presented on this page has been prepared by Dr. Kew and should not be taken as direct medical advice, merely education material to enhance a patient’s understanding of specific medical conditions. Each patient’s diagnosis is unique to the patient and requires a detailed examination and a discussion with Dr. Kew about potential treatment options. If you have specific questions about symptoms you are having and would like to discuss with Dr. Kew, please click below to contact our office to schedule a visit. We hope the information above allows our patients to more thoroughly understand their diagnosis and expands the lines of communication between Dr. Kew and her patients.